呼吁使公平在前线实践中变得可行,在学习健康系统中使用实施科学
Michelle S Wong1, Jennifer L Bryan2,3,4, Evelyn T Chang5,6
1HSR Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA. Michelle.wong6@va.gov.
Journal of general internal medicine
|September 25, 2025
概括
推进医疗保健中的健康公平需要实际应用实施科学. 本研究提供了可行的步骤和现实实例,以将健康公平纳入学习健康系统中的一线临床实践.
科学领域:
- 医疗保健服务研究 医疗服务研究
- 实施科学 实施科学
- 健康 公平 卫生 公平
背景情况:
- 健康公平是学习健康系统 (LHS) 五重目标的关键组成部分.
- 实施科学是LHS的基础方法,但缺乏应用公平性镜头的实际指导.
- 前线临床实践需要可行的策略来推进健康公平.
研究的目的:
- 通过实施科学,为前线临床实践中的健康公平能力建设提供建议.
- 介绍两项质量改进项目,展示在退伍军人卫生管理局中应用以公平为中心的实施科学.
- 引导研究人员制定干预措施和实施策略,以优先考虑健康公平.
主要方法:
- 针对管理高风险退伍军人的多层次,跨专业参与的经过调整的基于证据的质量改进 (EBQI) 战略.
- 利用临床运营伙伴关系和以公平为重点的实施框架,为有性暴力史的退伍军人提供心理治疗小组.
- 在国家学习健康系统 (退伍军人卫生管理局) 中利用了质量改进项目.
主要成果:
- 证明EBQI的成功适应,将健康公平纳入高风险退伍军人的初级保健.
- 通过运营伙伴关系和公平框架,展示了基于技能的心理治疗小组改善的公平交付.
- 提供了实用的见解,应用实施科学在医疗保健的第一线卫生公平.
结论:
- 实施科学的可行的步骤和实际应用可以有效地促进前线临床环境中的健康公平.
- 在学习健康系统中的质量改进项目为整合健康公平提供了有价值的模型.
- 研究人员应在干预设计和实施策略中优先考虑公平,以便在医疗保健中获得公平的结果.
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